Irvine, Kelly L.

Irvine, Kelly L. is an individual health care provider with primary practice located at 1000 W Nifong Blvd Bldg 6 , Columbia MO 65203-5615. She recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as her primary health care specialty. Irvine, Kelly L. can be contacted via phone (888) 403-1071.

Contact Information

Primary practice address
1000 W Nifong Blvd Bldg 6 Columbia MO 65203-5615
Phone: (888) 403-1071
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 2018042229 Missouri

Profile Details

NPI number 1134207269
LBN Legal business name Irvine, Kelly L.
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Aug 28th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134207269 NPPES
Other 50583 NRHSP IN PSYCH
Other NATIONAL REGISTER # NRHSP IN PSYCH
Other APA MEMBERSHIP # NRHSP IN PSYCH
Other AZ0616050 NRHSP IN PSYCH
Other 116730 NRHSP IN PSYCH
Other 5457314 NRHSP IN PSYCH
Other 415 NRHSP IN PSYCH
MEDICAID 141592 NRHSP IN PSYCH
MEDICAID 803925 NRHSP IN PSYCH
Other 2128566 NRHSP IN PSYCH
Other 228289 NRHSP IN PSYCH
Other 291968 NRHSP IN PSYCH
Other 4142 NRHSP IN PSYCH
Other 86-1043861 NRHSP IN PSYCH

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